Provider Demographics
NPI:1841174315
Name:COOLMAN, ALISSA
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:COOLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 873
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:LA
Mailing Address - Zip Code:71454-0873
Mailing Address - Country:US
Mailing Address - Phone:318-652-3755
Mailing Address - Fax:
Practice Address - Street 1:310 ROYAL ST
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5709
Practice Address - Country:US
Practice Address - Phone:318-352-2358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9821235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist